Okay, so now here I am with my post for Week 4 of this 20-week process.
For the past 5weeks I've been under the Processing area of the hospital that I've been attached to.Now, when I say Processing, it does not refer to the Processing of tissues that we learn in Histo Tech. It refers to Processing samples in general.
Here in Processing, it is very admin-like. My section is the first section that ALL samples and specimens have to go through before they are sent out to the respective labs like Blood Bank, Micro lab, Immuno lab, etc.
We have a pneumatic tube system that allows us to receive samples from the Wards and Specialist Clinics, ICUs, etc. The samples are placed in cannisters which are attached with a microchip and are sent down to the lab. This saves time for the porters and health attendants to send them down. This is because not every room has samples to be sent down each time, and it will be a waste of time to send down just one sample every now and then.
The same principle goes for the sending back of results or rejected specimens (which have been mislabelled, or sent in the wrong type of tubes, etc). Results which are for outpatients and prisoners (yes, we have a prison ward here in this hospital and we do testing of their samples as well), or those which are confidential will be placed in an envelope and will be sent back to the respective wards/clinics via the pneumatic system too. At the same time, the results will also be faxed to the respective places. However in super urgent cases, there will be porters that send down samples.
The samples which are from the operating theatres, A&E department, Specialist Clinics, or those specifically marked as 'URGENT' will be given priority. The same goes for blood gas samples, which have to be tested within an hour. I do not know why such a short time limit though, for I've not been attached to the Routine section yet. For the prioritzed samples, we will scan the time and put them ahead regardless of how many samples that are already in the queue. However, for samples which are to be tested in the Micro lab and the Histo lab, we will put in their respective separate trays and will be brought to the separate labs.
The other specimens are then keyed into the LIS, and a barcode will be auto generated This is done by first scanning in the patient's information label and then keying in the tests that have been ordered by the doctor. There is a code for every test that is run here in the lab. But before confirming the test, it is our duty to verify that all the samples are labelled correctly, the amount of specimen is enough, and that the right type of specimen is sent (e.g. EDTA tube used for FBC and not plain tube). If any of this conditions are not met, we will have to call the nurse/doctor in-charge of the patient and notify them. We will then either discard or send back the rejected sample.
For the accepted samples and specimens, after keying in the tests ordered, a barcode will then be generated for every test. We will then have to paste the barcodes onto the various test tubes carefully. We must ensure that the name on the barcode matches the name of the patient. We must then paste accordingly to the test. This is by looking at the number on the barcode. For samples that will have to be processed at haematology section, the number will begin with "21" e.g. 2164552 and for Biochemistry, "10" e.g. 1045189
Sometimes, one tube may be shared for various tests, therefore we must only label the test tube with one barcode, which is from the main section. For example, biochemistry tests like tsting of Troponin T will be given priority over an immunoassay test, for example the testing of Theophylline. Therefore, we only paste the Biochem barcode onto the test tube and staple the Immunology barcode on to the request form. Since there is only one request form sent from the ward for many tests sometimes, we issue separate 'tickets' for the different sections should there be a request for multiple tests from multiple sites. Eg. Test for Blood Gases and Full Blood Count are done at different sites. Once labeling has been done, we send it out to the different sections. Our lab is small, so each section is just a few steps away from my site. From the LIS, we then do billing for the tests ordered, but I'm not sure how this is done as I cannot learn billing.
I must stress the importance of checking patient's details as a wrong results may be generated, and it may result in the wrong diagnosis and medication given which may be life threatening.
I also forgot to mention that not every single test are done here in my hospital. Certain tests are done at other hospitals like SGH. This is for the tests that are not always requested for.
Anyway, I hope this hasn't been too wordy, but I've tried my best to describe the major details that I think needs to be highlighted and brought across in order for you to comprehend my routine duties at work.
Do clarify your doubts with me should there be a need to. (:
PS, I miss the food from ITAS.
For the past 5weeks I've been under the Processing area of the hospital that I've been attached to.Now, when I say Processing, it does not refer to the Processing of tissues that we learn in Histo Tech. It refers to Processing samples in general.
Here in Processing, it is very admin-like. My section is the first section that ALL samples and specimens have to go through before they are sent out to the respective labs like Blood Bank, Micro lab, Immuno lab, etc.
We have a pneumatic tube system that allows us to receive samples from the Wards and Specialist Clinics, ICUs, etc. The samples are placed in cannisters which are attached with a microchip and are sent down to the lab. This saves time for the porters and health attendants to send them down. This is because not every room has samples to be sent down each time, and it will be a waste of time to send down just one sample every now and then.
The same principle goes for the sending back of results or rejected specimens (which have been mislabelled, or sent in the wrong type of tubes, etc). Results which are for outpatients and prisoners (yes, we have a prison ward here in this hospital and we do testing of their samples as well), or those which are confidential will be placed in an envelope and will be sent back to the respective wards/clinics via the pneumatic system too. At the same time, the results will also be faxed to the respective places. However in super urgent cases, there will be porters that send down samples.
The samples which are from the operating theatres, A&E department, Specialist Clinics, or those specifically marked as 'URGENT' will be given priority. The same goes for blood gas samples, which have to be tested within an hour. I do not know why such a short time limit though, for I've not been attached to the Routine section yet. For the prioritzed samples, we will scan the time and put them ahead regardless of how many samples that are already in the queue. However, for samples which are to be tested in the Micro lab and the Histo lab, we will put in their respective separate trays and will be brought to the separate labs.
The other specimens are then keyed into the LIS, and a barcode will be auto generated This is done by first scanning in the patient's information label and then keying in the tests that have been ordered by the doctor. There is a code for every test that is run here in the lab. But before confirming the test, it is our duty to verify that all the samples are labelled correctly, the amount of specimen is enough, and that the right type of specimen is sent (e.g. EDTA tube used for FBC and not plain tube). If any of this conditions are not met, we will have to call the nurse/doctor in-charge of the patient and notify them. We will then either discard or send back the rejected sample.
For the accepted samples and specimens, after keying in the tests ordered, a barcode will then be generated for every test. We will then have to paste the barcodes onto the various test tubes carefully. We must ensure that the name on the barcode matches the name of the patient. We must then paste accordingly to the test. This is by looking at the number on the barcode. For samples that will have to be processed at haematology section, the number will begin with "21" e.g. 2164552 and for Biochemistry, "10" e.g. 1045189
Sometimes, one tube may be shared for various tests, therefore we must only label the test tube with one barcode, which is from the main section. For example, biochemistry tests like tsting of Troponin T will be given priority over an immunoassay test, for example the testing of Theophylline. Therefore, we only paste the Biochem barcode onto the test tube and staple the Immunology barcode on to the request form. Since there is only one request form sent from the ward for many tests sometimes, we issue separate 'tickets' for the different sections should there be a request for multiple tests from multiple sites. Eg. Test for Blood Gases and Full Blood Count are done at different sites. Once labeling has been done, we send it out to the different sections. Our lab is small, so each section is just a few steps away from my site. From the LIS, we then do billing for the tests ordered, but I'm not sure how this is done as I cannot learn billing.
I must stress the importance of checking patient's details as a wrong results may be generated, and it may result in the wrong diagnosis and medication given which may be life threatening.
I also forgot to mention that not every single test are done here in my hospital. Certain tests are done at other hospitals like SGH. This is for the tests that are not always requested for.
Anyway, I hope this hasn't been too wordy, but I've tried my best to describe the major details that I think needs to be highlighted and brought across in order for you to comprehend my routine duties at work.
Do clarify your doubts with me should there be a need to. (:
PS, I miss the food from ITAS.
Elyana
TG01
0606676E
TG01
0606676E
6 comments:
Hi Elyana,
Are you going to be attached to this section for the next 16 weeks?
I do AGREE it is very admin-liked. Do hope you can enjoy your attachment! :) By the way, you can indulge in the food from ITAS next Friday (for campus discussion, if I am not mistaken...)
I have some questions to ask you:
1)What is pneumatic tube system? Has it got to do with gases? Do you mind explaining the word 'pneumatic' with reference to your post?
2)How do samples placed in cannisters attached with a microchip saves time for the porters and health attendants?
3)"For samples that will have to be processed at haematology section, the number will begin with "21" e.g. 2164552 "
What does '64552' represents?
(Hmmm...Your 2nd sentence sounds abit wierd. What do you mean by "For the past 5weeks I've been under the Processing area of the hospital that I've been attached to."? I thought we at still at the 4th week? =P)
That's all! Thankz!
Han Yang
TG01
Elyana to Han Yang
hey Han Yang!
firstly, im so sorry for the mistake i made about 5 weeks. it's supposed to be 4 anod not 5. :p
anyway, here i am to answer your qns.
1) a pneumatic tube system refers to a system/mode of transportation by which samples/specimens are sent to the lab from other places (e.g. wards) without a human transporting them.
the samples are placed in cannisters and are placed in this pipe-looking thing. this thing is that automated by air pressure that will send the cannister to its destination. for more info, u can refer to http://www.swisslog.com/index/hcs-index/hcs-systems/hcs-pts.htm
they are the company that builds our pneumatic tube system.
2) the pneumatic tube saves time because we will need less manpower as this system is more or less automated. the nurses from the wards can place the patient's samples in the cannister and just place it into the tube system and it will reach the lab within few minutes. this is unlike using human resource which make take a long time to travel frm the 9th storey all the way down to the basement, which is where my lab is. also, it will prevent any samples being lost along the way due to human carelessness.it also saves us time when we need to send items / results to the wards. sometimes the wards request for certain tubes for specific tests (e.g. lactate test tubes) and we can send the specific wards the requested tubes immediately without waiting for a porter.
3) the remaining 5digit numbers are just an example. it refers to the test code for the machine to match its results with. this is because at one shot, a machine can analyse more than one sample sometimes, and this is for the machine to match the results to the numbers on the code.
i hope i've clarified your doubts. see you soon on Friday!
hello elyana,
what you have mentioned here is much similar to what i have been doing last week..
anyway just need to clarify. do you actually send the rejected sample back to the ward? because from what i know we don't. we will reject the sample and request for a new one..
sutiana
Haloo Elyana.. how are you? How's the food at your place? got halal western food or not? i dont know why, but i seem to be wanting to eat western food more often since i've been at my workplace. hehe.. *3 more days til you get your hands to ITAS food!*
The same goes for blood gas samples, which have to be tested within an hour. I do not know why such a short time limit though, for I've not been attached to the Routine section yet.
Okay, just to share.. from what i can remember from our Clinical Chemistry case study..
The blood gases test must be done Quickly because the cells in the arterial blood continue to use up the gas, eg. oxygen. if the test is delayed, we will get false result of the concentration of oxygen (i.e. lower than what it should be).
another way to minimise the problem is to keep the sample in ice during transport. what's the reason?
*hint: the temperature affects the rate of metabolism.*
so.....
.
.
.
.
.
.
you got it right! the low temperature will slow down the metabolism of oxygen.
sO cLeVer!!
hehe..
But.. i may have got some facts wrong. appreciate it if you guys (and girls @'---) could add more info if there's any.
Peace To The World!,
Nor Liyana
0607927A
Group8
Hey Sutiana
Sometimes the samples are sent back to the ward, depending on the situation, there are times, when the blood samples are unlabelled, therefore we need not have blood wastage and the wards will sent us the labels that have the patients' details on the tubes to us. Sometimes, we reject the test because the nurses/doctors have requested for the wrong test. (e.g. FBC for blood in plain tubes instead of EDTA tubes)
However for certain scenarios whereby there is no choice (e.g. blood has clotted) then we will just request for samples and we will discard the samples that have been given to us.
So hope that clarifies your doubts! :)
Hi Liyanah
FYI, the food here is quite disappointing. And yes, i jolly well look forward to eating at ITAS with my coursemates on friday.
Thank you for enlightening me on the blood gas sample. I forgot that we've done that for CCHEM case study!
Thanks again. :D
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